Sublingual immunotherapy for cedar pollinosis possibly triggers eosinophilic esophagitis.

Sublingual immunotherapy (SLIT) is an effective and popular treatment for cedar pollinosis. Although SLIT can cause allergic side effects, eosinophilic esophagitis (EoE) is a lesser-known side effect of SLIT. A 26-year-old male with cedar pollinosis, wheat-dependent exercise-induced anaphylaxis, and food allergies to bananas and avocados presented with persistent throat itching, difficulty swallowing, heartburn, and anterior chest pain 8 days after starting SLIT for cedar pollinosis. Laboratory examination showed remarkably elevated eosinophils, and esophagogastroduodenoscopy revealed linear furrows in the entire esophagus. Histological examination of an esophageal biopsy specimen revealed high eosinophil levels. The patient was strongly suspected with EoE triggered by SLIT. The patient was advised to switch from the swallow to the spit method for SLIT, and the symptoms associated with SLIT-triggered EoE were reduced after switching to the spit method. This case highlights the importance of recognizing SLIT-triggered EoE as a potential side effect of SLIT for cedar pollinosis, especially with the increasing use of SLIT in clinical practice. EoE can occur within a month after initiating SLIT in patients with multiple allergic conditions, as observed in our case. Furthermore, the spit method should be recommended for patients who experience SLIT-triggered EoE before discontinuing SLIT.

Multi-task machine learning improves multi-seasonal prediction of the Indian Ocean Dipole.

As one of the most predominant interannual variabilities, the Indian Ocean Dipole (IOD) exerts great socio-economic impacts globally, especially on Asia, Africa, and Australia. While enormous efforts have been made since its discovery to improve both climate models and statistical methods for better prediction, current skills in IOD predictions are mostly limited up to three months ahead. Here, we challenge this long-standing problem using a multi-task deep learning model that we name MTL-NET. Hindcasts of the IOD events during the past four decades indicate that the MTL-NET can predict the IOD well up to 7-month ahead, outperforming most of world-class dynamical models used for comparison in this study. Moreover, the MTL-NET can help assess the importance of different predictors and correctly capture the nonlinear relationships between the IOD and predictors. Given its merits, the MTL-NET is demonstrated to be an efficient model for improved IOD prediction.

Stabilised frequency of extreme positive Indian Ocean Dipole under 1.5 °C warming.

Extreme positive Indian Ocean Dipole (pIOD) affects weather, agriculture, ecosystems, and public health worldwide, particularly when exacerbated by an extreme El Niño. The Paris Agreement aims to limit warming below 2 °C and ideally below 1.5 °C in global mean temperature (GMT), but how extreme pIOD will respond to this target is unclear. Here we show that the frequency increases linearly as the warming proceeds, and doubles at 1.5 °C warming from the pre-industrial level (statistically significant above the 90% confidence level), underscored by a strong intermodel agreement with 11 out of 13 models producing an increase. However, in sharp contrast to a continuous increase in extreme El Niño frequency long after GMT stabilisation, the extreme pIOD frequency peaks as the GMT stabilises. The contrasting response corresponds to a 50% reduction in frequency of an extreme El Niño preceded by an extreme pIOD from that projected under a business-as-usual scenario.

Climate Based Predictability of Oil Palm Tree Yield in Malaysia.

The influence of local conditions and remote climate modes on the interannual variability of oil palm fresh fruit bunches (FFB) total yields in Malaysia and two major regions (Peninsular Malaysia and Sabah/Sarawak) is explored. On a country scale, the state of sea-surface temperatures (SST) in the tropical Pacific Ocean during the previous boreal winter is found to influence the regional climate. When El Niño occurs in the Pacific Ocean, rainfall in Malaysia reduces but air temperature increases, generating a high level of water stress for palm trees. As a result, the yearly production of FFB becomes lower than that of a normal year since the water stress during the boreal spring has an important impact on the total annual yields of FFB. Conversely, La Niña sets favorable conditions for palm trees to produce more FFB by reducing chances of water stress risk. The region of the Leeuwin current also seems to play a secondary role through the Ningaloo Niño/ Niña in the interannual variability of FFB yields. Based on these findings, a linear model is constructed and its ability to reproduce the interannual signal is assessed. This model has shown some skills in predicting the total FFB yield.

Inter-basin sources for two-year predictability of the multi-year La Niña event in 2010-2012.

Multi-year La Niña events often induce persistent cool and wet climate over global lands, altering and in some case mitigating regional climate warming impacts. The latest event lingered from mid-2010 to early 2012 and brought about intensive precipitation over many land regions of the world, particularly Australia. This resulted in a significant drop in global mean sea level despite the background upwards trend. This La Niña event is surprisingly predicted out to two years ahead in a few coupled models, even though the predictability of El Niño-Southern Oscillation during 2002-2014 has declined owing to weakened ocean-atmosphere interactions. However, the underlying mechanism for high predictability of this multi-year La Niña episode is still unclear. Experiments based on a climate model that demonstrates a successful two-year forecast of the La Niña support the hypothesis that warm sea surface temperature (SST) anomalies in the Atlantic and Indian Oceans act to intensify the easterly winds in the central equatorial Pacific and largely contribute to the occurrence and two-year predictability of the 2010-2012 La Niña. The results highlight the importance of increased Atlantic-Indian Ocean SSTs for the multi-year La Niña's predictability under global warming.

ENSO's far reaching connection to Indian cold waves.

During boreal winters, cold waves over India are primarily due to transport of cold air from higher latitudes. However, the processes associated with these cold waves are not yet clearly understood. Here by diagnosing a suite of datasets, we explore the mechanisms leading to the development and maintenance of these cold waves. Two types of cold waves are identified based on observed minimum surface temperature and statistical analysis. The first type (TYPE1), also the dominant one, depicts colder than normal temperatures covering most parts of the country while the second type (TYPE2) is more regional, with significant cold temperatures only noticeable over northwest India. Quite interestingly the first (second) type is associated with La Niña (El Niño) like conditions, suggesting that both phases of ENSO provide a favorable background for the occurrence of cold waves over India. During TYPE1 cold wave events, a low-level cyclonic anomaly generated over the Indian region as an atmospheric response to the equatorial convective anomalies is seen advecting cold temperatures into India and maintaining the cold waves. In TYPE2 cold waves, a cyclonic anomaly generated over west India anomalously brings cold winds to northwest India causing cold waves only in those parts.

Anatomy of Indian heatwaves.

India suffers from major heatwaves during March-June. The rising trend of number of intense heatwaves in recent decades has been vaguely attributed to global warming. Since the heat waves have a serious effect on human mortality, root causes of these heatwaves need to be clarified. Based on the observed patterns and statistical analyses of the maximum temperature variability, we identified two types of heatwaves. The first-type of heatwave over the north-central India is found to be associated with blocking over the North Atlantic. The blocking over North Atlantic results in a cyclonic anomaly west of North Africa at upper levels. The stretching of vorticity generates a Rossby wave source of anomalous Rossby waves near the entrance of the African Jet. The resulting quasi-stationary Rossby wave-train along the Jet has a positive phase over Indian subcontinent causing anomalous sinking motion and thereby heatwave conditions over India. On the other hand, the second-type of heatwave over the coastal eastern India is found to be due to the anomalous Matsuno-Gill response to the anomalous cooling in the Pacific. The Matsuno-Gill response is such that it generates northwesterly anomalies over the landmass reducing the land-sea breeze, resulting in heatwaves.

A Regional Climate Mode Discovered in the North Atlantic: Dakar Niño/Niña.

The interrannual variability of coastal sea surface temperature (SST) anomalies confined off Senegal is explored from a new viewpoint of the ocean-land-atmosphere interaction. The phenomenon may be classified into "coastal Niño/Niña" in the North Atlantic as discussed recently in the Northeastern Pacific and Southeastern Indian Oceans. The interannual variability of the regional mixed-layer temperature anomaly that evolves in boreal late fall and peaks in spring is associated with the alongshore wind anomaly, mixed-layer depth anomaly and cross-shore atmospheric pressure gradient anomaly, suggesting the existence of ocean-land-atmosphere coupled processes. The coupled warm (cold) event is named Dakar Niño (Niña). The oceanic aspect of the Dakar Niño (Niña) may be basically explained by anomalous warming (cooling) of the anomalously thin (thick) mixed-layer, which absorbs shortwave surface heat flux. In the case of Dakar Niña, however, enhancement of the entrainment at the bottom of the mixed-layer is not negligible.

Impacts of IOD, ENSO and ENSO Modoki on the Australian Winter Wheat Yields in Recent Decades.

Impacts of the Indian Ocean Dipole (IOD), two different types of El Niño/Southern Oscillation (ENSO): canonical ENSO and ENSO Modoki, on the year-to-year winter wheat yield variations in Australia have been investigated. It is found that IOD plays a dominant role in the recent three decades; the wheat yield is reduced (increased) by -28.4% (12.8%) in the positive (negative) IOD years. Although the canonical ENSO appears to be responsible for the wheat yield variations, its influences are largely counted by IOD owing to their frequent co-occurrence. In contrast, the ENSO Modoki may have its distinct impacts on the wheat yield variations, but they are much smaller compared to those of IOD. Both the observed April-May and the predicted September-November IOD indices by the SINTEX-F ocean-atmosphere coupled model initialized on April 1st just before the sowing season explain ~15% of the observed year-to-year wheat yield variances. The present study may lead to a possible scheme for predicting wheat yield variations in Australia in advance by use of simple climate mode indices.

More-frequent extreme northward shifts of eastern Indian Ocean tropical convergence under greenhouse warming.

The Intertropical Convergence Zone (ITCZ) in the tropical eastern Indian Ocean exhibits strong interannual variability, often co-occurring with positive Indian Ocean Dipole (pIOD) events. During what we identify as an extreme ITCZ event, a drastic northward shift of atmospheric convection coincides with an anomalously strong north-minus-south sea surface temperature (SST) gradient over the eastern equatorial Indian Ocean. Such shifts lead to severe droughts over the maritime continent and surrounding islands but also devastating floods in southern parts of the Indian subcontinent. Understanding future changes of the ITCZ is therefore of major scientific and socioeconomic interest. Here we find a more-than-doubling in the frequency of extreme ITCZ events under greenhouse warming, estimated from climate models participating in the Coupled Model Intercomparison Project phase 5 that are able to simulate such events. The increase is due to a mean state change with an enhanced north-minus-south SST gradient and a weakened Walker Circulation, facilitating smaller perturbations to shift the ITCZ northwards.

Increased frequency of extreme Indian Ocean Dipole events due to greenhouse warming.

The Indian Ocean dipole is a prominent mode of coupled ocean-atmosphere variability, affecting the lives of millions of people in Indian Ocean rim countries. In its positive phase, sea surface temperatures are lower than normal off the Sumatra-Java coast, but higher in the western tropical Indian Ocean. During the extreme positive-IOD (pIOD) events of 1961, 1994 and 1997, the eastern cooling strengthened and extended westward along the equatorial Indian Ocean through strong reversal of both the mean westerly winds and the associated eastward-flowing upper ocean currents. This created anomalously dry conditions from the eastern to the central Indian Ocean along the Equator and atmospheric convergence farther west, leading to catastrophic floods in eastern tropical African countries but devastating droughts in eastern Indian Ocean rim countries. Despite these serious consequences, the response of pIOD events to greenhouse warming is unknown. Here, using an ensemble of climate models forced by a scenario of high greenhouse gas emissions (Representative Concentration Pathway 8.5), we project that the frequency of extreme pIOD events will increase by almost a factor of three, from one event every 17.3 years over the twentieth century to one event every 6.3 years over the twenty-first century. We find that a mean state change--with weakening of both equatorial westerly winds and eastward oceanic currents in association with a faster warming in the western than the eastern equatorial Indian Ocean--facilitates more frequent occurrences of wind and oceanic current reversal. This leads to more frequent extreme pIOD events, suggesting an increasing frequency of extreme climate and weather events in regions affected by the pIOD.

Impacts of El Niño Southern Oscillation on the global yields of major crops.

The monitoring and prediction of climate-induced variations in crop yields, production and export prices in major food-producing regions have become important to enable national governments in import-dependent countries to ensure supplies of affordable food for consumers. Although the El Niño/Southern Oscillation (ENSO) often affects seasonal temperature and precipitation, and thus crop yields in many regions, the overall impacts of ENSO on global yields are uncertain. Here we present a global map of the impacts of ENSO on the yields of major crops and quantify its impacts on their global-mean yield anomalies. Results show that El Niño likely improves the global-mean soybean yield by 2.1-5.4% but appears to change the yields of maize, rice and wheat by -4.3 to +0.8%. The global-mean yields of all four crops during La Niña years tend to be below normal (-4.5 to 0.0%). Our findings highlight the importance of ENSO to global crop production.

California Niño/Niña.

The present study shows the existence of intrinsic coastal air-sea coupled phenomenon in the coastal ocean off Baja California and California in boreal summer for the first time. It contributes significantly to the interannual sea surface temperature (SST) anomalies there. An initial decrease/increase in the equatorward alongshore surface winds weakens/strengthens the coastal upwelling and raises/lowers the coastal SSTs through oceanic mixed-layer processes. The resultant coastal warming/cooling, in turn, heats/cools the overlying atmosphere anomalously, decreases/increases the atmospheric pressure in the lower troposphere, generates an anomalous cross-shore pressure gradient, and thus reinforces or maintains the alongshore surface wind anomalies. The regional air-sea coupled phenomenon seems to be analogous to the well-known El Niño/Southern Oscillation (ENSO) in the tropical Pacific but with much smaller time and space scales, and may be referred to as California Niño/Niña in its intrinsic sense.

Predictability of the Ningaloo Niño/Niña.

The seasonal prediction of the coastal oceanic warm event off West Australia, recently named the Ningaloo Niño, is explored by use of a state-of-the-art ocean-atmosphere coupled general circulation model. The Ningaloo Niño/Niña, which generally matures in austral summer, is found to be predictable two seasons ahead. In particular, the unprecedented extreme warm event in February 2011 was successfully predicted 9 months in advance. The successful prediction of the Ningaloo Niño is mainly due to the high prediction skill of La Niña in the Pacific. However, the model deficiency to underestimate its early evolution and peak amplitude needs to be improved. Since the Ningaloo Niño/Niña has potential impacts on regional societies and industries through extreme events, the present success of its prediction may encourage development of its early warning system.

Acute myocardial infarction following hormone replacement in hypothyroidism.

Patients with hypothyroidism have an increased risk of coronary artery disease because of significant changes in lipid metabolism and arterial hypertension. We report a 67-year-old man who developed acute myocardial infarction following hormone replacement in hypothyroidism in spite of no previous cardiac symptoms and no ischemia in intravenous dipyridamole myocardial perfusion imaging. Careful examination for ischemic heart disease should be performed before hormone replacement in hypothyroidism.

Decline of plasma brain natriuretic peptide level after carvedilol therapy to treat dilated cardiomyopathy presenting with mechanical alternans.

Mechanical alternans is observed in patients with severe left ventricular dysfunction. We report a case of dilated cardiomyopathy with mechanical alternans. He presented with a remarkable decrease in plasma brain natriuretic peptide (BNP) levels after beta-blocker therapy despite persistency of the mechanical alternans. Mechanical alternans may persist after improvement of hemodynamics, diastolic function, and plasma BNP levels. Mechanical alternans may reflect persistent organic or functional myocardial damage such as abnormal intracellular Ca(2+) cycling in cardiomyocytes.

Asymmetric evolution of eddies in rotating shallow water.

It is demonstrated that cyclones evolve in a way different from that of anticyclones in rotating shallow water. The anticyclones merge and eventually take circular coherent forms, but cyclones are elongated with active enstrophy cascading. This asymmetric evolution is strengthened with increasing surface displacements. When the initial surface displacement exceeds a certain critical value, the initial elongation of a cyclonic ellipse ends up with splitting in two cyclones. This splitting of the cyclonic ellipse is always associated with the first appearance of a saddle point inside the core, due to irrotational, ageostrophic motion. The appearance of the saddle point inside the core seems to be a necessary condition for splitting of the core of the cyclonic ellipse with surface displacements. The linear stability analysis of the elliptical vortex is consistent qualitatively with both of the simulation results and the kinematic axisymmetrization/elongation principle.